Behavior Problems in Infancy: A Preventive Intervention

描述（由申请人提供）：本指导患者导向研究职业发展奖（K23）的目标是为Bagner博士准备一个独立的临床研究生涯，专注于为婴儿及其家庭开发预防性干预措施。Bagner博士的长期职业目标是发展一个跨学科的研究项目，研究对有外化行为问题风险的婴儿的有效干预措施，并帮助推进有其他行为和情绪问题的婴儿的循证实践。在K23培训计划的背景下，Bagner博士的短期培训目标是：(1)获得关于婴儿发展的独特过程的专门培训，包括典型和风险人群，以及基于关系的干预的性质；(2)获得设计、执行和分析以婴儿及其家庭为基础的预防试验的知识和专业知识；(3)拓宽对与开展低收入家庭干预研究相关的伦理和多元文化问题的理解。本培训计划将得到以下方面的促进：(a)博士的专家指导。温迪·西尔弗曼、巴里·莱斯特、大卫·奥尔兹、洛林·巴里克、爱丽丝·卡特、詹姆斯·雅卡德、威廉·佩勒姆和何塞·罗莎-奥利瓦雷斯；(b)正式课程和研讨会；(c)定向读数；(d)在婴儿心理健康领域有重点的临床经验；佛罗里达国际大学和迈阿密儿童医院可利用的各种资源；(f)拟议研究项目的实施。Bagner博士将实施一项为期5年的研究，在该研究中，他将开发和评估对有外化行为问题风险的婴儿进行预防性干预的潜在功效。干预将是亲子互动疗法的一种改编，用于家庭环境中的婴儿（即pct - i）。拟议拨款的头18个月将致力于发展pit - i，并在公开试验中进行试点。随后，Bagner博士将进行一项比较pct - i和标准治疗的小型随机试验。关于pct - i的可行性和可接受性以及结果的临床意义的数据，结合统计分析的结果，将用于通知II期临床试验的R01申请。

DESCRIPTION (provided by applicant): The goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to prepare Dr. Bagner for an independent clinical research career focused on developing preventive interventions for infants and their families. Dr. Bagner's long-term career goals are to develop a transdiciplinary research program examining effective interventions for infants at risk for externalizing behavior problems and help advance evidence-based practice for infants with other behavioral and emotional problems. In the context of the K23 training plan, Dr. Bagner's short-term training goals are to: (1) acquire specialized training in the unique processes of infant development, including typical and at-risk populations, and the nature of relationship-based interventions; (2) gain knowledge and expertise in the design, execution, and analysis of conducting home- based prevention trials with infants and their families; and (3) broaden understanding of ethical and multicultural issues relevant to conducting intervention research with low-income families. This training plan will be facilitated by: (a) expert mentorship from Drs. Wendy Silverman, Barry Lester, David Olds, Lorraine Bahrick, Alice Carter, James Jaccard, William Pelham, and Jose Rosa-Olivares; (b) formal coursework and seminars; (c) directed readings; (d) focused clinical experiences in the area of infant mental health; (e) the diverse resources available at Florida International University and Miami Children's Hospital; and (f) implementation of the proposed research project. Dr. Bagner will implement a 5-year research study in which he will develop and evaluate the potential efficacy of a preventive intervention for infants at risk for externalizing behavior problems. The intervention will be an adaptation of Parent-Child Interaction Therapy for use with infants in the home setting (i.e., PCIT-I). The first 18 months of the proposed award will be devoted to developing PCIT-I and piloting it in an open trial. Subsequently, Dr. Bagner will conduct a small randomized trial comparing PCIT-I to standard care. Data concerning the feasibility and acceptability of PCIT-I and clinical significance of findings, combined with results from statistical analyses, will be used to inform an R01 application for a stage II clinical trial. PUBLIC HEALTH RELEVANCE: Negative outcomes of early externalizing behavior problems in childhood are overrepresented in low-income families and represent a significant public health concern. Despite recent findings that externalizing behavior problems can be identified as early as 12 months, there has been limited research examining the prevention of later externalizing behavior problems in infants from low-income families.